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Index - Major Sections
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IntroductionIdentification is one of the greatest problems in health care in attempting to identify a client across time and space? Inherent to any client information system is the requirement that the client must be accurately identified. Without the ability to uniquely identify the client, health care organizations will be unable to manage that client's health care needs, researchers will be unable to track diseases across time and space, and the client suffers. Any error in assigning an identification to a client at the onset, propagates throughout the entire system. The object of many countries Healthcare Initiative is to provide for communication between systems. It becomes difficult or impossible to relate disparate records relate to the same individual. The first solution that has been recommended is the creation of a Master Patient Index system to reconcile patient identifiers and their records. But then if you do not know the identification of the individual in each of the data sets, how do you find the correct Identification in the Master Patient Index. The solution is and has always been is to give everyone an Universal Unique Identifier. IdentifiersIdentifiers for people and places are an essential perquisite to any sharing of patient data across organizations and locations. While a unique identifier is necessary for the identification of an individual or location, it is not necessary to actually identify that individual or location for research. Many individuals notions of freedom encompasses anonymity, so any form of universal identification may be difficult to achieve. In health care, the price for such anonymity, however, may be lack of lifesaving information and added cost. In many developing countries, it is this added cost that can kill. The lack of money for health care is probably the biggest killer of all. The most important item in the success of health care is the ability to track an individual over time and location. It is only by applying a time variant analysis to events can these events truly be understood. Client IdentifiersIn many countries, the citizens are assigned an identification number by the local government. Where this occurs, this assigned number (social security number, etc) may be used on all records. (see Patient Identification under "Security"). A unique world patient identifier must be created where the client has the ability to move between government areas (different coding systems). This unique code may only be created in some way using the client's own biological make-up. ProblemsIn developing countries where many clients do not know their date of birth, much less, have a national identification number, the problem of correctly assigning the client correctly is magnified.
MultiplesAs errors are introduced into the system over time and across locations, they lead to an ever increasing numbers of other errors. An example is when two identification numbers are assigned to the same client. When the client returns later, the client may be assigned a third number because the HCP is unable to chose between the two "clients" that she already has on record. VerificationA verification program, much as that used in Internet searchers of the Web, can be used to assign a probability to the patient being that of the patient assigned that patient identification number. This verification program can cross check such things as name, address, age, father's name, etc. Based on this items matching, a probability can be assigned. Before the data is added to the centralized data warehouse, the information must be verified by the health care worker as being the "true patient."
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